Noviembre-Diciembre

More documents

Recommendations

Info

Multidisciplinary teams involved: detection of drug-related problems… Farm Hosp. 2016;40(6):529-543 - 535 System also features this role 21 . The so-called Integrated Healthcare Organizations have been created in Catalonia 22 and in the Basque Country 23 . Our project is based on the role of the Pharmacist as the integrator of Continuity of Care in a multidisciplinary setting, who will communicate any DRP detected. In a DRP study conducted by German Pharmacists, 271 DRPs were detected in 105 patients within a period of 6 months 24 . Our study includes more patients and a lower number of interventions, but data are similar. The drugs upon which more frequent interventions have been conducted are those included in Groups B, N, A and C. These data coincide with the medications upon which more interventions have been conducted in other studies described in bibliography 25,26 . This result can be due to the fact that Group N medications are some of the most widely used 27; regarding Group B, this can be caused by the incorporation of new oral anticoagulants to the market. These medications are prescribed by specialists and are subject to standardization (in Galicia, this standardization is conducted by PC and SC Pharmacists). The most frequent DRPs are similar to those described in bibliography. Thus, in the reconciliation study by Ucha-Samartin 28 , the most common DRP was dosing/ inadequate interval. The actions in this project were to detect and solve DRPs, and any DRP prevented translates into adverse reaction prevention, reduction of visits to Emergency, and even prevention of re-hospitalizations 29 . Our project intends to add, improve, and provide new ideas to the concept of Continuity of Care, by involving the Pharmacist in patient care, and making them participate in the responsibility required by a safe and efficient drug therapy. The inclusion of the Pharmacist has a very important value in Continuity of Care, because this study was focused on healthcare education and identification of warming signs. A Pharmacist integrated in a multidisciplinary team will also be able to participate in the preparation of protocols for medication follow-up and reports, as well as acting upon adherence and other areas. The connection between the Primary Care Physician and the Primary Care Pharmacist and/ or the SC Physician and the SC Pharmacist already existed within the same level of care. The additional value of this project was to join SC and PC through Pharmacist groups, as they are the professionals who will detect the DRP and communicate it to the rest of the multidisciplinary team. One of the limitations of this study is that an integrated clinical record is required for its extrapolation, and not all autonomous communities have access to this system. However, any country or autonomous community with Pharmacists in both levels (even from the Community Pharmacy setting), will be able to set up similar multidisciplinary models of action. On the other hand, our outcomes don’t allow us to obtain data about the reduction in number of re-hospitalizations or preventable deaths, as these are not the object of our practice of care. In the future, it will be necessary to validate this program, to quantify the severity of the DRPs detected, and to measure the economic impact of their prevention. It will also be necessary to measure the benefit achieved by optimization the drug therapy of patients, increasing the safety of the Continuity of Care process. Despite these limitations, we consider that the number of interventions is adequate in order to create awareness in professionals regarding the fact that Transition of Care is a real problem in our health system, regardless of the existence of integrated clinical records. The strengths of an on-going, safe and integrated Program for Transition of Care are: to ensure the best outcome in drug therapy for patients, and to guarantee access to the medication with an efficient and effective use. An adequate Transition of Care represents a challenge for the health system. If there is no adequate continuity, and the impenetrability of levels of care is not eliminated, DRPs will appear that can generate additional costs for the patient and the system; therefore, projects like this represent an improvement in patient care, as has been demonstrated by other studies 30 . Summing up, discrepancies / DRPs in patient records regarding drug therapy were detected and solved through the implementation of the e-CC Program among Pharmacists in both levels of care, with a high acceptance of interventions (84%). Conflict of Interests The authors hereby declare that there is no conflict of interests. Bibliography 1. EuropeanPatients Smart Open Service (epSOSproject) [página web]. [Consultando el 07/05/2015]. Disponible en: http://www. epsos.eu/home/epsos-results-outlook.html 2. InnovaSaude y Hospital2050 [página web]. [Consultando el 08/05/2015]. Disponible en: http://www.sergas.es/MostrarContidos_N2_T01.aspx?IdPaxina=60433 3. Gálvez Ibáñez. Continuidad asistencial. Análisis conceptual, de los actores y amenazas. Propuestas y alternativas. Medicina de Familia (And) [revista en Internet]. 2003 [citado 30/04/2014]; 4(1):58-66. Disponible en: http://www.samfyc.es/Revista/PDF/v 4 n1/09.pdf 4. Reid R, Haggerty J, McKendry R. Defusing the confusion: Concepts and measures of continuity of healthcare [Canada]. Ottawa; 2002. [consultando 30/01/2015]. Disponible en: http://www.cfhifcass.ca/Migrated/PDF/ResearchReports/CommissionedResearch/ cr_contcare_e.pdf 5. Estrategia SERGAS 2014. La Sanidad Pública al servicio del Paciente [Monografía en Internet]. Galicia: Servicio Gallego de Salud y Xunta de Galicia; 2014 [citado 8/11/2015]. Disponible en: http:// www.sergas.es/Docs/Conselleria/Estrategia_Sergas_2014.pdf 6. Delgado-Silveira E, Fernández-Villalba EM, García-Mina Freire M, Albiñana Pérez MS, CasajúsLagranja MP, Peris Martí JF. [The impact of Pharmacy Intervention on the treatment of elderly multi-pathological patients].FarmHosp. 2015;39(4):192-202. 7. Galván Banqueri M, Alfaro Lara ER, Rincón Gómez M, Rivas Covas PC, Vega Coca MD, Nieto Martín MD. Factors related with the appropriateness of pharmacological treatment in polypathological patients. FarmHosp. 2014;38(5):405-10.
536 - Farm Hosp. 2016;40(6):529-543 Elena Yaiza Romero-Ventosa et al. 8. Estratificación del riesgo de cronificación en AP-Madrid [Monografía en Internet]. Madrid: Fisioterapia en Fisioterapia y Salud Pública; 2015 [citado 14/09/2016]. Disponible en: http://www.fisioenap.com/estratificacion-del-riesgo-de-cronificacion-en-ap-madrid/#sthash.YG 1 FORdI.dpbs 9. Estrategia para afrontar el reto de la cronicidad en Euskadi [Monografía en Internet]. Euskadi; 2010 [citado 14/09/2016]. Disponible en: http://www.osakidetza.euskadi.eus/r85-skorga01/es/contenidos/informacion/estrategia_cronicidad/es_cronicos/estrategia_cronicidad.html 10. Plan Estratégico de la Sociedad Española de Farmacia Hospitalaria sobre Atención Farmacéutica al Paciente Crónico [Monografía en Internet]. SEFH; 2012 [citado 14/09/2016]. Disponible en: http:// www.sefh.es/sefhpdfs/plan_estrategico_sefh_af_paciente_cronico2012.pdf 11. Reboredo-García S, González-Criado Mateo C, Casal-Llorente. Implantación de un programa de polimedicados en el marco de la Estrategia Gallega de Atención Integral a la Cronicidad. Aten Primaria. 2014;46 (Supl 3):33-40. 12. Comité de consenso: grupo de investigación en atención farmacéutica. Universidad de Granada (Spain). Grupo de investigación en farmacología. Universidad de granada (Spain). FundacionPharmaceuticalCare España. Sociedad española de farmacia comunitaria (SEFaC). Tercer Consenso de Granada sobre Problemas Relacionados con Medicamentos (PRM) y Resultados Negativos asociados a la Medicacion (RNM). ArsPharm [revista en Internet]. 2007 [citado 10/11/2014];48(1):5-17. Disponible en: http://adm.online.unip. br/img_ead_dp/35344.PDF 13. Terraza Núnez R, Vargas Lorenzo I, Vázquez Navarrete ML. La coordinación entre niveles asistenciales: una sistematización de sus instrumentos y medidas. GacSanit [revista en Internet]. 2006 [citado 05/11/2014]; 20(6):485-95. Disponible en: http://scielo.isciii.es/ pdf/gs/v2 0 n6/revision.pdf 14. Van der Stuyft P, De Vos P. La relación entre los niveles de atención constituye un determinante clave de la salud. Rev. cub. salud pública [revista en Internet]. 2008 [citado 05/11/2014]; 34(4). Disponible en: http://scielo.sld.cu/scielo.php?pid=S0864-34662008000400014&script=sci_arttext 15. Aranaz JM, Buil JA. Gestión Sanitaria: acerca de la coordinación entre niveles asistenciales. Med Clin (Barc). 1995;106:182-4. 16. Ministry of Health. Government of British Columbia: Expanded Chronic Care Model [página web]. [Consultando el 10/11/2014]. Disponible en: http://www.primaryhealthcarebc.ca/resource_eccm.html 17. Pérez RM, López SR, Lacida M, Rodríguez Gómez S. La enfermera comunitaria de enlace en el Servicio Andaluz de Salud. EnfComun [revista en Internet]. 2005 [citado 01/08/2015]; 1 (1):43-48. Disponible en: http://www.index-f.com/comunitaria/ 1 revista/1_articulo_43-48.php 18. Gorgas Torner MQ, PàezVives F, CamósRamió J, de Puig Cabrera E, JolonchSantasusagna P, Homs Peipoch E, et al.; [Integrated pharmaceutical care programme in patients with chronic diseases]. [Article in Spanish].Farm Hosp. 2012;36(4):229-39. 19. Redondo Martín S, Bolaños Gallardo E, Almaraz Gómez A, Maderuelo Fernández JA. Percepciones y expectativas sobre la atención primaria de salud: una nueva forma de identificar mejoras en el sistema de atención. Aten Primaria. 2005;36(7):358-66. 20. Protocolo del Servicio de Continuidad de Cuidados para la Atención Domiciliaria [Monografía en Internet]. Canarias: Servicio Canario de Salud; [consultando el 10/11/2015]. Disponible en: http:// www3.gobiernodecanarias.org/sanidad/scs/content/92138516- ed42-1 1 dd-95 8 f-c5070 9 d67 7 ea/Portocolo_SCCAD.pdf 21. Servicio Andaluz de Salud. Manual de Gestión de Casos en Andalucía: enfermeras gestoras de casos en el hospital [consultando el 27/07/2016]. Disponible en: http://www.juntadeandalucia.es/servicioandaluzdesalud/library/plantillas/externa.asp?pag=../../contenidos/gestioncalidad/Manual%2 0 Gesti%F 3 n%2 0 de%2 0 Casos%2 0 en%2 0 Andaluc%EDa.pdf 22. Vázquez Navarrete ML, Vargas Lorenzo I. Organizaciones sanitarias integradas. Un estudio de casos. [Monografía en Internet]. Barcelona: ConsorciHospitalari de Catalunya; 2007 [citado 11/11/2015]. Disponible en: http://www.consorci.org/media/upload/pdf/osi_un_ estudio_de_casos_1432545988.pdf 23. Jauregui ML. Experiencia en el País Vasco: Organización Sanitaria Integrada (OSI) [Monografía en Internet]. País Vasco: Osakidetza; [citado 11/11/2014]. Disponible en: http://www.fundaq.org/imagenes/cargaweb/files/ExperienciaenelPaisVasco.pdf 24. Hohmann C, Neumann-Haefelin T, Klotz JM, Freidank A, Radziwill R.Drug-related problems in patients with ischemic stroke in hospital.Int J Clin Pharm. 2012;34(6):828-31. 25. Pippins JR, Gandhi TK, Hamann C, Ndumele CD, Labonville SA, Diedrichsen EK, et al. Classifying and Predicting Errors of Inpatient Medication Reconciliation. J Gen Intern Med. 2008;23(9):1414-22. 26. Ucha-Samartín M, Pichel-Loureiro A, Vázquez-López C, ÁlvarezPayero M, Pérez Parente D, Martínez-López de Castro N. [Economic impact of the resolution of drug related problems in an Emergency Department]. [Article in Spanish]. Farm Hosp 2013;37(1):59-64. 27. Ministerio de Sanidad Servicios Sociales e Igualdad. Informe de utilización de medicamentos U/HAY/V1/17012014. Utilización de medicamentos ansiolíticos e hipnóticos en España durante el periodo 2000-2012. [Monografía en Internet]. 2014 [citada 27/07/2015]. Disponible en:http://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/ansioliticos_hipnoticos-2000-2012.pdf 28. Ucha-Sanmartín M. Análisis de los problemas relacionados con los medicamentos tras la integración de un farmacéutico en un servicio de urgencias. Emergencias 2012;24:96-100. 29. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009;150(3):178-87. 30. Morera-Llorca M, Romeu-Climentb JE, Lera-Calatayudb G, Folch-Marín B, Palop-Larrea V, Vidal-Rubio S. Experiencia de colaboración entre atención primaria y salud mental en el Departamento de Salud La Ribera, 7 años después. GacSanit. 2014;28(5):405-7. Aportación a la literatura científica La transición asistencial es un punto crítico en el sistema sanitario. Establecer modelos multidisciplinares que garanticen una correcta Continuidad Asistencial es clave para el actual modelo sanitario basado en la cronicidad. Nuestros resultados demuestran la importancia de incluir a los farmacéuticos en los Programas multidisciplinares de Continuidad Asistencial, para garantizar la seguridad y eficacia de los tratamientos. Introducción A lo largo de los años, se han producido cambios culturales, tecnológicos y socioeconómicos en la sociedad, que plantean nuevos retos en la organización del sistema sanitario. La sanidad en nuestro Sistema Nacional de Salud está estructurada en comunidades autónomas y los servicios autonómicos de salud, están compuestos por todos los centros y establecimientos sanitarios que garantizan la asistencia sanitaria pública, debiendo todos ellos trabajar conjuntamente, independientemente
Page 1 and 2:
Farmacia HOSPITALARIA ISSN-L: 1130-
Page 3 and 4:
JUNTA DE GOBIERNO SOCIEDAD ESPAÑOL
Page 5 and 6:
Carta de la directora Madrid, 26 de
Page 7 and 8:
Sumario (cont.) Volumen 40. Número
Page 9 and 10:
Contents (cont.) Volume 40. Number
Page 11 and 12:
458 - Farm Hosp. 2016;40(6):457-476
Page 13 and 14:
460 - Farm Hosp. 2016;40(6):457-476
Page 15 and 16:
462 - Farm Hosp. 2016;40(6):457-476
Page 17 and 18:
464 - Farm Hosp. 2016;40(6):457-476
Page 19 and 20:
466 - Farm Hosp. 2016;40(6):457-476
Page 21 and 22:
468 - Farm Hosp. 2016;40(6):457-476
Page 23 and 24:
470 - Farm Hosp. 2016;40(6):457-476
Page 25 and 26:
472 - Farm Hosp. 2016;40(6):457-476
Page 27 and 28:
474 - Farm Hosp. 2016;40(6):457-476
Page 29 and 30:
476 - Farm Hosp. 2016;40(6):457-476
Page 31 and 32:
478 - Farm Hosp. 2016;40(6):477-485
Page 33 and 34:
480 - Farm Hosp. 2016;40(6):477-485
Page 35 and 36:
482 - Farm Hosp. 2016;40(6):477-485
Page 37 and 38: 484 - Farm Hosp. 2016;40(6):477-485
Page 39 and 40: Farm Hosp. 2016;40(6):486-490 ORIGI
Page 87: 534 - Farm Hosp. 2016;40(6):529-543
Page 139 and 140:
586 - Farm Hosp. 2016;40(6):579-603
Page 141 and 142:
588 - Farm Hosp. 2016;40(6):579-603
Page 143 and 144:
590 - Farm Hosp. 2016;40(6):579-603
Page 145 and 146:
592 - Farm Hosp. 2016;40(6):579-603
Page 147 and 148:
594 - Farm Hosp. 2016;40(6):579-603
Page 149 and 150:
596 - Farm Hosp. 2016;40(6):579-603
Page 151 and 152:
598 - Farm Hosp. 2016;40(6):579-603
Page 153 and 154:
600 - Farm Hosp. 2016;40(6):579-603
Page 155 and 156:
602 - Farm Hosp. 2016;40(6):579-603
Page 157 and 158:
Farm Hosp. 2016;40(6):604-621 REVIS
Page 159 and 160:
606 - Farm Hosp. 2016;40(6):604-621
Page 161 and 162:
608 - Farm Hosp. 2016;40(6):604-621
Page 163 and 164:
610 - Farm Hosp. 2016;40(6):604-621
Page 165 and 166:
612 - Farm Hosp. 2016;40(6):604-621
Page 167 and 168:
614 - Farm Hosp. 2016;40(6):604-621
Page 169 and 170:
616 - Farm Hosp. 2016;40(6):604-621
Page 171 and 172:
618 - Farm Hosp. 2016;40(6):604-621
Page 173 and 174:
620 - Farm Hosp. 2016;40(6):604-621
Page 175 and 176:
Farm Hosp. 2016;40(6):622-623 CARTA
Page 177 and 178:
Farm Hosp. 2016;40(6):624-626 CARTA
Page 179 and 180:
626 - Farm Hosp. 2016;40(6):624-626
Page 181 and 182:
628 - Farm Hosp. 2016;40(6):627-639
Page 183 and 184:
630 - Farm Hosp. 2016;40(6):627-639
Page 185 and 186:
632 - Farm Hosp. 2016;40(6):627-639
Page 187 and 188:
634 - Farm Hosp. 2016;40(6):627-639
Page 189 and 190:
Farm Hosp. 2016;40(6):627-639 Índi
Page 191 and 192:
638 - Farm Hosp. 2016;40(6):627-639
show all

Noviembre-Diciembre

Create successful ePaper yourself

Delete template?

Save as template?